Abstract
Introduction: When COVID-19 patients develop hypoxaemic respiratory failure, they often undergo early intubation. Such a potentially aerosol-generating approach places caregivers at increased risk of contracting COVID-19. This protocol aims to evaluate the clinical efficacy and safety of a high-flow nasal cannula (HFNC) for the treatment of COVID-19 patients with acute hypoxaemic respiratory failure.
Methods and analysis: We intend to search MEDLINE, Embase, Web of Science and Cochrane Library to identify all randomised controlled trials (RCTs) on the use of HFNC in COVID-19 patients with acute respiratory failure. We will screen the RCTs against eligibility criteria for inclusion in our review. Two reviewers will independently undertake RCT selection, data extraction and risk of bias assessment. Primary outcome will be the rate of intubation, and secondary outcomes will be intensive care unit (ICU)/hospital mortality, ICU/hospital length of stay and risks of infection transmission. We will conduct meta-analyses to determine the risk ratio for dichotomous data and the mean difference (MD) or standardised MD for continuous data. Subgroup analyses will be performed based on the different quality of studies, different levels of disease severity, and the age and sex of participants.
Ethics and dissemination: Ethical approval is not required for this study considering this is a systematic review protocol that uses only published data. The findings of this study will be disseminated through peer-reviewed publications and conference presentations.
Prospero registration number: CRD42021236519.
Keywords: Adult intensive & critical care; COVID-19; Respiratory infections.
【저자키워드】 COVID-19, Critical care, respiratory infections., adult intensive &, 【초록키워드】 Treatment, respiratory infections, randomised controlled trial, protocol, Critical care, Respiratory failure, Mortality, intensive care, disease severity, Ethics, intensive care unit, Acute respiratory failure, systematic review, intubation, risk, nasal, outcome, RCT, infections, Caregivers, HFNC, eligibility criteria, respiratory, Intensive, Critical, COVID-19 patients, RCTs, Clinical efficacy, High-flow nasal cannula, meta-analyses, Infection transmission, risk ratio, COVID-19 patient, registration number, nasal cannula, Subgroup analyses, Web of Science, Participants, Primary outcome, PROSPERO, increased risk, Secondary outcomes, data extraction, Cochrane Library, secondary outcome, mean difference, Ethical approval, Continuous data, hypoxaemic respiratory failure, approach, identify, performed, develop, evaluate, required, undergo, determine, the mean, age and sex, meta-analysis, peer-reviewed, for inclusion, risk of bia, Subgroup analysis, 【제목키워드】 Meta-analysis, protocol, systematic review, nasal, clinical, Patient, Efficacy and safety,